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目的 采用射频超声血管定量技术检测慢性丙型肝炎（chronic hepatitis c,CHC）患者的颈总动脉弹性，分析CHC与颈总动脉弹性的相关性。 方法 选取70例CHC患者(慢性肝炎组）和64例年龄性别匹配、无肝病病史的健康人（正常对照组），对以上两组研究对象分别进行肝脏声辐射力脉冲（acoustic radiation force impulse,ARFI）成像检查和颈总动脉射频超声检查，记录一般项目、生化指标、颈总动脉弹性参数和肝脏硬度参数，颈动脉弹性参数包括血管内中膜厚度（intima-media thickness,IMT），脉搏波传导速度（pulse wave velocity,PWV），动脉管壁扩张性系数（distention coefficient,DC）和顺应性系数（compliance coefficient,CC），硬度指数α、β，动脉增强指数（augmentation index,AIx）。比较正常对照组和CHC组患者组各项参数，比较CHC患者左右侧颈总动脉弹性差异，比较不同糖耐量水平CHC患者颈动脉弹性的差异。 结果 ①CHC患者组的体质量指数（BMI）、空腹血糖(FPG)、糖化血红蛋白、天门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、白蛋白、血小板等临床指标均显著高于正常对照组（均P<0.05）。②CHC患者ARFI值显著高于对照组〔(1.86±0.37)m/s vs.(1.04±0.11)m/s〕。 CHC组颈总动脉的PWV〔(8.0±1.4)m/s vs.(6.1±0.9)m/s〕、DC〔(0.017±0.008)1/kPa vs.(0.032±0.008)1/kPa〕、CC〔(0.82±0.38)mm2/kPa vs.(1.29±0.25)mm2/kPa〕、α(5.8±2.3 vs. 3.0±0.8)、β(11.7±4.5 vs. 6.2±1.6)等弹性参数与正常对照组差异显著（均P<0.01）。③CHC患者FPG升高组的IMT高于空腹血糖正常组（P<0.01）；前者PWV、α、β高于后者，DC、CC低于后者。④CHC患者的FPG与IMT、PWV、α、β正相关（P<0.05），与DC、CC负相关（P<0.05）。结论 CHC患者不仅肝脏硬度明显增加，而且颈动脉弹性参数也发生变化。利用ARFI技术和射频超声无创检测CHC患者的肝脏硬度和颈动脉弹性参数，对CHC患者心血管事件的监测有一定帮助。
Objective To detect the common carotid artery elasticity in patients with chronic hepatitis C (CHC) by radiofrequency sonography and analyze the correlation between CHC and common carotid artery elasticity. Methods Seventy patients with CHC (chronic hepatitis group) and 64 age-matched healthy controls without any history of liver disease (normal control group) were enrolled in this study. The acoustic emission force impulse (ARFI) ) Imaging examination and common carotid artery radiofrequency ultrasound were performed. The general items, biochemical parameters, common carotid artery elasticity parameters and liver stiffness parameters were recorded. The parameters of carotid artery elasticity included intima-media thickness (IMT), pulse wave transmission Pulse wave velocity (PWV), arterial wall dilatation coefficient (DC) and compliance coefficient (CC), hardness index α, β, augmentation index (AIx). The parameters of CHC group and normal control group were compared. The differences of carotid artery elasticity between CHC patients and CHC patients were compared. Results ① The clinical indexes of body mass index (BMI), fasting blood glucose (FPG), glycosylated hemoglobin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin and platelet in patients with CHC Significantly higher than the normal control group (all P & lt; 0.05). ② The ARFI of CHC patients was significantly higher than that of the control group [(1.86 ± 0.37) m / s vs. (1.04 ± 0.11) m / s〕. PWV 〔(8.0 ± 1.4) m / s vs. (6.1 ± 0.9) m / s〕, DC 〔(0.017 ± 0.008) 1 / kPa vs. (0.032 ± 0.008) 1 / kPa〕 in the common carotid artery of CHC group, The elastic parameters such as CC (0.82 ± 0.38) mm2 / kPa vs. (1.29 ± 0.25) mm2 / kPa], α (5.8 ± 2.3 vs. 3.0 ± 0.8) and β (11.7 ± 4.5 vs. 6.2 ± 1.6) The control group had significant differences (all P & lt; 0.01). (3) The IMT of elevated FPG in CHC group was higher than that in normal group (P <0.01). The former PWV, α, β were higher than the latter, while DC and CC were lower than the latter. ④ The FPG of patients with CHC was positively correlated with IMT, PWV, α, β (P <0.05), negatively correlated with DC and CC (P <0.05). Conclusion CHC patients not only significantly increased liver stiffness, and carotid artery elastic parameters also changed. The use of ARFI technology and radio-frequency non-invasive detection of CHC in patients with liver stiffness and carotid artery elasticity parameters, monitoring of cardiovascular events in patients with CHC will be helpful.